Changes in antioxidant status associated with haemodialysis in chronic kidney disease

Oxidative stress has been implicated in the pathogenesis, progression of chronic kidney disease (CKD) and development of cardiovascular complications. Hemodialysis (HD) has also been described to contribute significantly to oxidative stress in CKD patients, though reports are conflicting.Objective: We evaluated the effects of one session of HD on the antioxidant capacity and lipid peroxidation in CKD patients.Method: Thirty-six CKD patients requiring HD were recruited into this study. Participants were naïve to HD and each completed a session of three hours using polysulfone membrane dialyzers. Blood samples were collected before and after dialysis. Total antioxidant capacity (TAC) was measured by ferric reducing antioxidant power (FRAP) while malondialdehyde (MDA) was measured using thiobarbituric acid-reactive substance (TBARS). Comparison was made between pre-HD and post-HD values of TAC and MDA respectively, p value of <0.05 was taken as significant.Result: Mean age and estimated glomerular filtration rate of subjects were 45 ±15 years and 6.3± 4.7mls/1.73m2 respectively. There was significant decrease in the mean TAC from 1232.2 ± 495.6 μmol Trolox equiv/ to 832.4 ±325.7 μmol Trolox equiv/L post-dialysis (p< 0.001) while MDA values were similar before and after HD (11.8 ± 1.8 vs 11.8 ± 2.331)μmol/L (p> 0.05). There was no significant association between changes in antioxidant status following HD with blood flow rate, ultrafiltration volume nor dialyzer per size.Conclusion: A session of HD in patients with CKD is associated with significant reduction of the total antioxidants capacity; and no effect on MDA levels.Funding: No external funding receivedKeywords: oxidative stress, antioxidants capacity, hemodialysis, chronic kidney diseas

Physical activity and breast cancer survival

Physical activity improves quality of life after a breast cancer diagnosis, and a beneficial effect on survival would be particularly welcome. Four observational studies have now reported decreased total mortality among physically active women with breast cancer; the two largest have also reported decreased breast cancer specific mortality. The estrogen pathway and the insulin pathway are two potential mechanisms by which physical activity could affect breast cancer survival. Randomized trials are ongoing but trials of lifestyle factors are notoriously challenging to perform. Women with breast cancer have little to lose and may possibly gain from moderate exercise

Urinary tract infections and antibiotic sensitivity pattern of uropathogens in a tertiary hospital in South West, Nigeria

Background: Urinary tract infection (UTI) is one of the factors implicated in morbidity among patients. Early diagnosis and treatment of UTI could be pivotal in overall treatment outcome. Aims: The aim of this study was to determine the prevalence of UTI, identify common isolates in UTI cases, and their in vitro sensitivity and resistance patterns to common antibiotics. Materials and Methods: This was a retrospective descriptive study of 181 patients with microbiological indications for UTI conducted between April 2014 and September 2015. Results: Out of 181 patients aged 20–86 years with a mean age of 51.43 ± 17.2 years, 79 (43.6%) had positive bacterial growth for uropathogens. Most common predisposing factors were urethral catheterization (32.5%), diabetes mellitus (23.7%), and urinary tract obstruction (18.7%). UTI was found to be more predominant among females (55.7%). The common isolates were Escherichia coli 30 (37.9%), Klebsiella pneumoniae 27 (34.2%), Pseudomonas aeruginosa 10 (12.7%), Proteus mirabilis 8 (10.1%), Enterococcus faecalis 3 (3.8%), Acinetobacter baumannii 1 (1.3%). The isolates were sensitive to nitrofurantoin and ciprofloxacin and ofloxacin while they were highly resistant to cotrimoxazole and tetracycline. Conclusions: UTI is common among patients affecting 43.6% of the participants in this study with E. coli being the most common uropathogen. ciprofloxacin, ofloxacin, and nitrofurantoin could therefore be recommended as the first line of drugs to clinicians for empirical treatment while awaiting sensitivity results. To prevent the emergence of resistant strains, rational use of drugs is encouraged